BACKGROUND
[0001] Continuous monitoring of heart rate, and in particular, heart rate variability, provides
valuable insights into workout intensity and recovery. Monitoring of sleep provides
additional useful information, and while the general relationship between sleep and
physical recovery is well known, there remains a need for accurate instrumentation
and quantification of physical recovery resulting from sleep.
US 2014/073486A1 discloses a fatigue monitoring and management system.
SUMMARY
[0002] A system i according to the present invention, the scope of which is solely defined
by the appended claims, uses continuous tracking of sleep activity and heart rate
activity to evaluate heart rate variability immediately before transitioning to an
awake state, e.g., at the end of the last phase of deep sleep. In particular, a wearable,
continuous physiological monitoring system as described herein includes one or more
sensors to detect sleep states, the transitions between sleep states, and the transitions
from a sleep state to an awake state for a user. This information is used in conjunction
with continuously monitored heart rate data to calculate heart rate variability of
the user at the end of the last phase of sleep preceding the user waking up. By using
the history of heart rate data in conjunction with sleep activity in this manner,
an accurate and consistent recovery score is calculated based on heart rate variability.
[0003] In one embodiment of the invention, a method disclosed herein includes a method of
operating a wearable, continuous physiological monitoring system comprising: detecting
a sleep state of a user; monitoring a heart rate of the user substantially continuously
with the continuous physiological monitoring system; recording the heart rate as heart
rate data; detecting a waking event at a transition from the sleep state of the user
to an awake state; calculating a heart rate variability of the user at a moment in
a last phase of sleep preceding the waking event based upon the heart rate data; and
calculating a recovery score for the user based upon the heart rate variability from
the last phase of sleep.
[0004] The method may include calculating additional recovery scores after one or more other
waking events of the user for comparison to the recovery score. The method may include
calculating a duration of the sleep state and using the duration to calculate the
recovery score.
The method may include detecting the sleep state using an accelerometer of the wearable,
continuous physiological monitoring system. The method may include detecting the waking
event using the accelerometer. The method may include detecting a galvanic skin response
(GSR) of the user with the wearable, continuous physiological monitoring system and
using the GSR to detect the sleep state. The method may include detecting at least
one of the sleep state and the waking event based upon the heart rate data.
[0005] Recording the heart rate data may include recording the heart rate data continuously
without calculating the heart rate variability. The method includes detecting a slow
wave sleep period occurring most recently before the waking event. The method includes
evaluating a quality of heart rate data using a data quality metric for the slow wave
sleep period; and calculating the heart rate variability for a window of predetermined
duration within the slow wave sleep period having a highest quality of heart rate
data according to the data quality metric. The wearable, continuous physiological
monitoring system may include a processor, one or more light emitting diodes, and
one or more light detectors configured to obtain the heart rate data from the user.
[0006] In another aspect, a system disclosed herein includes a wearable housing; one or
more sensors in the wearable housing; and a processor in the wearable housing, the
processor configured to operate the one or more sensors to detect a sleep state of
a user wearing the wearable housing, to monitor a heart rate of the user substantially
continuously, to record the heart rate as heart rate data without calculating a heart
rate variability for the user, to detect a waking event at a transition from the sleep
state of the user to an awake state, to calculate the heart rate variability of the
user at a moment in a last phase of sleep preceding the waking event based upon the
heart rate data, and to calculate a recovery score for the user based upon the heart
rate variability from the last phase of sleep.
[0007] The one or more sensors may include a light detector configured to provide data to
the processor for calculating the heart rate variability. The one or more sensors
may include an accelerometer configured to provide data to the processor for detecting
the sleep state or the waking event. The system may include a light source coupled
to the housing and controlled by the processor, the light source directed toward a
skin on an appendage of the user. The one or more sensors may measure a galvanic skin
response of the user.
[0008] In another embodiment of the invention, there is disclosed herein a computer program
product for operating a wearable, continuous physiological monitoring system, the
computer program product comprising computer executable code embodied in a non-transitory
computer readable medium that, when executing on the wearable, continuous physiological
monitoring system, performs the steps of: detecting a sleep state of a user; monitoring
a heart rate of the user substantially continuously with the continuous physiological
monitoring system; recording the heart rate as heart rate data; detecting a waking
event at a transition from the sleep state of the user to an awake state; calculating
a heart rate variability of the user at a moment in a last phase of sleep preceding
the waking event based upon the heart rate data; and calculating a recovery score
for the user based upon the heart rate variability from the last phase of sleep.
[0009] The computer program product may include code that performs the step of calculating
additional recovery scores after one or more other waking events of the user for comparison
to the recovery score. The computer program product may include code that performs
the step of calculating a duration of the sleep state and using the duration to calculate
the recovery score. The computer program product may include code that performs the
step of detecting at least one of the sleep state and the waking event using an accelerometer
of the wearable, continuous physiological monitoring system.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] The foregoing and other objects, features, and advantages of the devices, systems,
and methods described herein will be apparent from the following description of particular
embodiments thereof, as illustrated in the accompanying figures. The figures are not
necessarily to scale, emphasis instead being placed upon illustrating the principles
of the devices, systems, and methods described herein.
Fig. 1 illustrates front and back perspective views of a wearable system configured
as a bracelet including one or more straps.
Fig. 2 shows a block diagram illustrating components of a wearable physiological measurement
system configured to provide continuous collection and monitoring of physiological
data.
Fig. 3 is a flowchart illustrating a signal processing algorithm for generating a
sequence of heart rates for every detected heartbeat that may be embodied in computer-executable
instructions stored on one or more non-transitory computer-readable media.
Fig. 4 is a flowchart illustrating a method of determining an intensity score.
Fig. 5 is a flowchart illustrating a method by which a user may use intensity and
recovery scores.
Fig. 6 is a flow chart illustrating a method for detecting heart rate variability
in sleep states.
Fig. 7 is a bottom view of a wearable, continuous physiological monitoring device
DETAILED DESCRIPTION
[0011] The disclosure will now be described more fully hereinafter with reference to the
accompanying figures, in which embodiments and examples are shown. The foregoing may,
however, be embodied in many different forms and should not be construed as limited
to the illustrated embodiments set forth herein.
[0012] References to items in the singular should be understood to include items in the
plural, and vice versa, unless explicitly stated otherwise or clear from the text.
Grammatical conjunctions are intended to express any and all disjunctive and conjunctive
combinations of conjoined clauses, sentences, words, and the like, unless otherwise
stated or clear from the context. Thus, the term "or" should generally be understood
to mean "and/or" and so forth.
[0013] Recitations of ranges of values herein are not intended to be limiting, referring
instead individually to any and all values falling within the range, unless otherwise
indicated herein, and each separate value within such a range is incorporated into
the specification as if it were individually recited herein. The words "about," "approximately,"
or the like, when accompanying a numerical value, are to be construed as including
any deviation as would be appreciated by one of ordinary skill in the art to operate
satisfactorily for an intended purpose, or where applicable, any acceptable range
of deviation appropriate to a measurement of the numerical value or achievable by
instrumentation used to measure the amount. Ranges of values and/or numeric values
are provided herein as examples only, and do not constitute a limitation on the scope
of the described embodiments. The use of any and all examples, or exemplary language
("e.g.," "such as," or the like) provided herein, is intended merely to better illuminate
the embodiments and does not pose a limitation on the scope of the embodiments. No
language in the specification should be construed as indicating any unclaimed element
as essential to the practice of the embodiments.
[0014] In the following description, it is understood that terms such as "first," "second,"
"above," "below," and the like, are words of convenience and are not to be construed
as limiting terms.
[0015] Exemplary embodiments provide physiological measurement systems, devices and methods
for continuous health and fitness monitoring, and provide improvements to overcome
the drawbacks of conventional heart rate monitors. One aspect of the present disclosure
is directed to providing a lightweight wearable system with a strap that collects
various physiological data or signals from a wearer. The strap may be used to position
the system on an appendage or extremity of a user, for example, wrist, ankle, and
the like. Exemplary systems are wearable and enable real-time and continuous monitoring
of heart rate without the need for a chest strap or other bulky equipment which could
otherwise cause discomfort and prevent continuous wearing and use. The system may
determine the user's heart rate without the use of electrocardiography and without
the need for a chest strap. Exemplary systems can thereby be used in not only assessing
general well-being but also in continuous monitoring of fitness. Exemplary systems
also enable monitoring of one or more physiological parameters in addition to heart
rate including, but not limited to, body temperature, heart rate variability, motion,
sleep, stress, fitness level, recovery level, effect of a workout routine on health
and fitness, caloric expenditure, and the like.
[0016] A health or fitness monitor that includes bulky components may hinder continuous
wear. Existing fitness monitors often include the functionality of a watch, thereby
making the health or fitness monitor quite bulky and inconvenient for continuous wear.
Accordingly, one aspect is directed to providing a wearable health or fitness system
that does not include bulky components, thereby making the bracelet slimmer, unobtrusive
and appropriate for continuous wear. The ability to continuously wear the bracelet
further allows continuous collection of physiological data, as well as continuous
and more reliable health or fitness monitoring. For example, embodiments of the bracelet
disclosed herein allow users to monitor data at all times, not just during a fitness
session. In some embodiments, the wearable system may or may not include a display
screen for displaying heart rate and other information. In other embodiments, the
wearable system may include one or more light emitting diodes (LEDs) to provide feedback
to a user and display heart rate selectively. In some embodiments, the wearable system
may include a removable or releasable modular head that may provide additional features
and may display additional information. Such a modular head can be releasably installed
on the wearable system when additional information display is desired, and removed
to improve the comfort and appearance of the wearable system. In other embodiments,
the head may be integrally formed in the wearable system.
[0017] Exemplary embodiments also include computer-executable instructions that, when executed,
enable automatic interpretation of one or more physiological parameters to assess
the cardiovascular intensity experienced by a user (embodied in an intensity score
or indicator) and the user's recovery after physical exertion or daily stress given
sleep and other forms of rest (embodied in a recovery score). These indicators or
scores may be stored and displayed in a meaningful format to assist a user in managing
his health and exercise regimen. Exemplary computer-executable instructions may be
provided in a cloud implementation. Examplary embodiments also include a website that,
e.g., allows users to monitor their own fitness results, share information with their
teammates and coaches, compete with other users, and so forth. Both the wearable system
and the website allow a user to provide feedback regarding his/her day, exercise and/or
sleep, which enables recovery and performance ratings.
[0018] In an exemplary technique of data transmission, data collected by a wearable system
may be transmitted directly to a cloud-based data storage, from which data may be
downloaded for display and analysis on a website. In another exemplary technique of
data transmission, data collected by a wearable system may be transmitted via a mobile
communication device application to a cloud-based data storage, from which data may
be downloaded for display and analysis on a website.
[0019] The term "user" as used herein, refers to any type of animal, human or non-human,
whose physiological information may be monitored using an exemplary wearable physiological
monitoring system. The term "body," as used herein, refers to the body of a user.
[0020] The term "continuous," as used herein in connection with heart rate data collection,
refers to collection of heart rate data at a sufficient frequency to enable detection
of every heart beat and also refers to collection of heart rate data continuously
throughout the day and night.
[0021] The term "computer-readable medium," as used herein, refers to a non-transitory storage
hardware, non-transitory storage device or non-transitory computer system memory that
may be accessed by a controller, a microcontroller, a computational system or a module
of a computational system to encode thereon computer-executable instructions or software
programs. The "computer-readable medium" may be accessed by a computational system
or a module of a computational system to retrieve and/or execute the computer-executable
instructions or software programs encoded on the medium. The non-transitory computer-readable
media may include, but are not limited to, one or more types of hardware memory, non-transitory
tangible media (for example, one or more magnetic storage disks, one or more optical
disks, one or more USB flash drives), computer system memory or random access memory
(such as, DRAM, SRAM, EDO RAM) and the like.
[0022] Exemplary embodiments provide wearable physiological measurements systems that are
configured to provide continuous measurement of heart rate. Exemplary systems are
configured to be continuously wearable on an appendage, for example, wrist or ankle,
and do not rely on electrocardiography or chest straps in detection of heart rate.
The exemplary system includes one or more light emitters for emitting light at one
or more desired frequencies toward the user's skin, and one or more light detectors
for received light reflected from the user's skin. The light detectors may include
a photo-resistor, a photo-transistor, a photo-diode, and the like. As light from the
light emitters (for example, green light) pierces through the skin of the user, the
blood's natural absorbance or transmittance for the light provides fluctuations in
the photo-resistor readouts. These waves have the same frequency as the user's pulse
since increased absorbance or transmittance occurs only when the blood flow has increased
after a heartbeat. The system includes a processing module implemented in software,
hardware or a combination thereof for processing the optical data received at the
light detectors and continuously determining the heart rate based on the optical data.
The optical data may be combined with data from one or more motion sensors, e.g.,
accelerometers and/or gyroscopes, to minimize or eliminate noise in the heart rate
signal caused by motion or other artifacts (or with other optical data of another
wavelength).
[0023] Figure 1 illustrates front and back perspective views of one embodiment of a wearable
system configured as a bracelet 100 including one or more straps 102. The bracelet
is sleek and lightweight, thereby making it appropriate for continuous wear. The bracelet
may or may not include a display screen, e.g., a screen 106 such as a light emitting
diode (LED) display for displaying any desired data (e.g., instantaneous heart rate).
[0024] As shown in Figure 1, the wearable system may include components configured to provide
various functions such as data collection and streaming functions of the bracelet.
In some embodiments, the wearable system may include a button underneath the wearable
system. In some embodiments, the button may be configured such that, when the wearable
system is properly tightened to one's wrist, the button may press down and activate
the bracelet to begin storing information. In other embodiments, the button may be
disposed and configured such that it may be pressed manually at the discretion of
a user to begin storing information or otherwise to mark the start or end of an activity
period such as sleep. In some embodiments, the button may be held to initiate a time
stamp and held again to end a time stamp, which may be transmitted, directly or through
a mobile communication device application, to a website as a time stamp.
[0025] The wearable system may include a heart rate monitor. In one example, the heart rate
may be detected from the radial artery. Thus, the wearable system may include a pulse
sensor. In one embodiment, the wearable system may be configured such that, when a
user wears it around their wrist and tightens it, the sensor portion of the wearable
system is secured over the user's radial artery or other blood vessel. Secure connection
and placement of the pulse sensor over the radial artery or other blood vessel may
allow measurement of heart rate and pulse. It will be understood that this configuration
is provided by way of example only, and that other sensors, sensor positions, and
monitoring techniques may also or instead be employed without departing from the scope
of this disclosure.
[0026] In some embodiments, the pulse or heart rate may be taken using an optical sensor
coupled with one or more light emitting diodes (LEDs), all directly in contact with
the user's wrist. The LEDs are provided in a suitable position from which light can
be emitted into the user's skin. In one example, the LEDs mounted on a side or top
surface of a circuit board in the system to prevent heat buildup on the LEDs and to
prevent bums on the skin. The circuit board may be designed with the intent of dissipating
heat, e.g., by including thick conductive layers, exposed copper, heatsink, or similar.
In one aspect, the pulse repetition frequency is such that the amount of power thermally
dissipated by the LED is negligible. Cleverly designed elastic wrist straps can ensure
that the sensors are always in contact with the skin and that there is a minimal amount
of outside light seeping into the sensors. In addition to the elastic wrist strap,
the design of the strap may allow for continuous micro adjustments (no preset sizes)
in order to achieve an optimal fit, and a floating sensor module. The sensor module
may be free to move with the natural movements caused by flexion and extension of
the wrist.
[0027] In some embodiments, the wearable system may be configured to record other physiological
parameters including, but not limited to, skin temperature (using a thermometer),
galvanic skin response (using a galvanic skin response sensor), motion (using one
or more multi-axes accelerometers and/or gyroscope), and the like, and environmental
or contextual parameters, e.g., ambient temperature, humidity, time of day, and the
like. In an implementation, sensors are used to provide at least one of continuous
motion detection, environmental temperature sensing, electrodermal activity (EDA)
sensing, galvanic skin response (GSR) sensing, and the like. In this manner, an implementation
can identify the cause of a detected physiological event. Reflectance PhotoPlethysmoGraphy
(RPPG) may be used for the detection of cardiac activity, which may provide for non-intrusive
data collection, usability in wet, dusty and otherwise harsh environments, and low
power requirements. For example, as explained herein, using the physiological readouts
of the device and the analytics described herein, an "Intensity Score" (e.g., 0-21)
(e.g., that measures a user's recent exertion), a "Recovery Score" (e.g., 0-100%),
and "Sleep Score" (e.g., 0-100) may together measure readiness for physical and psychological
exertion.
[0028] In some embodiments, the wearable system may further be configured such that a button
underneath the system may be pressed against the user's wrist, thus triggering the
system to begin one or more of collecting data, calculating metrics and communicating
the information to a network. In some embodiments, the sensor used for, e.g., measuring
heart rate or GSR or any combination of these, may be used to indicate whether the
user is wearing the wearable system or not. In some embodiments, power to the one
or more LEDs may be cut off as soon as this situation is detected, and reset once
the user has put the wearable system back on their wrist.
[0029] The wearable system may include one, two or more sources of battery life, e.g., two
or more batteries. In some embodiments, it may have a battery that can slip in and
out of the head of the wearable system and can be recharged using an included accessory.
Additionally, the wearable system may have a built-in battery that is less powerful.
When the more powerful battery is being charged, the user does not need to remove
the wearable system and can still record data (during sleep, for example).
[0030] In exemplary embodiments, the wearable system is enabled to automatically detect
when the user is asleep, awake but at rest and exercising based on physiological data
collected by the system.
[0031] Figure 2 shows a block diagram illustrating exemplary components of a wearable physiological
measurement system 200 configured to provide continuous collection and monitoring
of physiological data. The wearable system 200 includes one or more sensors 202. As
discussed above, the sensors 202 may include a heart rate monitor. In some embodiments,
the wearable system 200 may further include one or more of sensors for detecting calorie
burn, distance and activity. Calorie burn may be based on a user's heart rate, and
a calorie burn measurement may be improved if a user chooses to provide his or her
weight and/or other physical parameters. In some embodiments, manual entering of data
is not required in order to derive calorie burn; however, data entry may be used to
improve the accuracy of the results. In some embodiments, if a user has forgotten
to enter a new weight, he/she can enter it for past weeks and the calorie burn may
be updated accordingly.
[0032] The sensors 202 may include one or more sensors for activity measurement. In some
embodiments, the system may include one or more multi-axes accelerometers and/or gyroscope
to provide a measurement of activity. In some embodiments, the accelerometer may further
be used to filter a signal from the optical sensor for measuring heart rate and to
provide a more accurate measurement of the heart rate. In some embodiments, the wearable
system may include a multi-axis accelerometer to measure motion and calculate distance,
whether it be in real terms as steps or miles or as a converted number. Activity sensors
may be used, for example, to classify or categorize activity, such as walking, running,
performing another sport, standing, sitting or lying down. In some embodiments, one
or more of collected physiological data may be aggregated to generate an aggregate
activity level. For example, heart rate, calorie burn, and distance may be used to
derive an aggregate activity level. The aggregate level may be compared with or evaluated
relative to previous recordings of the user's aggregate activity level, as well as
the aggregate activity levels of other users.
[0033] The sensors 202 may include a thermometer for monitoring the user's body or skin
temperature. In one embodiment, the sensors may be used to recognize sleep based on
a temperature drop, GSR data, lack of activity according to data collected by the
accelerometer, and reduced heart rate as measured by the heart rate monitor. The body
temperature, in conjunction with heart rate monitoring and motion, may be used to
interpret whether a user is sleeping or just resting, as body temperature drops significantly
when an individual is about to fall asleep), and how well an individual is sleeping
as motion indicates a lower quality of sleep. The body temperature may also be used
to determine whether the user is exercising and to categorize and/or analyze activities.
[0034] The system 200 includes one or more batteries 204. According to one embodiment, the
one or more batteries may be configured to allow continuous wear and usage of the
wearable system. In one embodiment, the wearable system may include two or more batteries.
The system may include a removable battery that may be recharged using a charger.
In one example, the removable battery may be configured to slip in and out of a head
portion of the system, attach onto the bracelet, or the like. In one example, the
removable battery may be able to power the system for around a week. Additionally,
the system may include a built-in battery. The built-in battery may be recharged by
the removable battery. The built-in battery may be configured to power the bracelet
for around a day on its own. When the more removable battery is being charged, the
user does not need to remove the system and may continue collecting data using the
built-in battery. In other embodiments, the two batteries may both be removable and
rechargeable.
[0035] In some embodiments, the system 200 may include a battery that is a wireless rechargeable
battery. For example, the battery may be recharged by placing the system or the battery
on a rechargeable mat. In other example, the battery may be a long range wireless
rechargeable battery. In other embodiments, the battery may be a rechargeable via
motion. In yet other embodiments, the battery may be rechargeable using a solar energy
source.
[0036] The wearable system 200 includes one or more non-transitory computer-readable media
206 for storing raw data detected by the sensors of the system and processed data
calculated by a processing module of the system.
[0037] The system 200 includes a processor 208, a memory 210, a bus 212, a network interface
214, and an interface 216. The network interface 214 is configured to wirelessly communicate
data to an external network 218. The network 218 may include any communication network
through which computer systems may exchange data. For example, the network 218 may
include, but is not limited to, the Internet, an intranet, a LAN (Local Area Network),
a WAN (Wide Area Network), a MAN (Metropolitan Area Network), a wireless network,
an optical network, and the like. To exchange data via the network 218, the system
200 and the network 218 may use various methods, protocols and standards including,
but not limited to, token ring, Ethernet, wireless Ethernet, Bluetooth, TCP/IP, UDP,
HTTP, FTP, SNMP, SMS, MMS, SS7, JSON, XML, REST, SOAP, CORBA, HOP, RMI, DCOM and Web
Services. To ensure data transfer is secure, the system 200 may transmit data via
the network using a variety of security measures including, but not limited to, TSL,
SSL and VPN.
[0038] Some embodiments of the wearable system may be configured to stream information wirelessly
to a social network. In some embodiments, data streamed from a user's wearable system
to an external network 218 may be accessed by the user via a website. The network
interface may be configured such that data collected by the system may be streamed
wirelessly. In some embodiments, data may be transmitted automatically, without the
need to manually press any buttons. In some embodiments, the system may include a
cellular chip built into the system. In one example, the network interface may be
configured to stream data using Bluetooth technology. In another example, the network
interface may be configured to stream data using a cellular data service, such as
via a 3G or 4G cellular network.
[0039] The system 200 may be coupled to one or more servers 220 via a communication network
218.
[0040] In some embodiments, a physiological measurement system may be configured in a modular
design to enable continuous operation of the system in monitoring physiological information
of a user wearing the system. The module design may include a strap and a separate
modular head portion or housing that is removably couplable to the strap.
[0041] In the non-limiting illustrative module design, the strap 102 of a physiological
measurement system may be provided with a set of components that enables continuous
monitoring of at least a heart rate of the user so that it is independent and fully
self-sufficient in continuously monitoring the heart rate without requiring the modular
head portion 104. In one embodiment, the strap includes a plurality of light emitters
for emitting light toward the user's skin, a plurality of light detectors for receiving
light reflected from the user's skin, an electronic circuit board comprising a plurality
of electronic components configured for analyzing data corresponding to the reflected
light to automatically and continually determine a heart rate of the user, and a first
set of one or more batteries for supplying electrical power to the light emitters,
the light detectors and the electronic circuit board. In some embodiments, the strap
may also detect one or more other physiological characteristics of the user including,
but not limited to, temperature, galvanic skin response, and the like.
[0042] Certain exemplary systems may be configured to be coupled to any desired part of
a user's body so that the system may be moved from one portion of the body (e.g.,
wrist) to another portion of the body (e.g., ankle) without affecting its function
and operation. In one embodiment, the identity of the portion of the user's body to
which the wearable system is attached may be determined based on one or more parameters
including, but not limited to, absorbance level of light as returned from the user's
skin, reflectance level of light as returned from the user's skin, motion sensor data
(e.g., accelerometer and/or gyroscope), altitude of the wearable system, and the like.
[0043] In some embodiments, the processing module is configured to determine that the wearable
system is taken off from the user's body. In one example, the processing module may
determine that the wearable system has been taken off if data from the galvanic skin
response sensor indicates data atypical of a user's skin. If the wearable system is
determined to be taken off from the user's body, the processing module is configured
to deactivate the light emitters and the light detectors and cease monitoring of the
heart rate of the user to conserve power.
[0044] Exemplary systems include a processing module configured to filter the raw photoplethysmography
data received from the light detectors to minimize contributions due to motion, and
subsequently process the filtered data to detect peaks in the data that correspond
with heart beats of a user. The overall algorithm for detecting heart beats takes
as input the analog signals from optical sensors (mV) and accelerometer, and outputs
an implied beats per minute (heart rate) of the signal accurate within a few beats
per minute as that determined by an electrocardiography machine even during motion.
[0045] In one aspect, using multiple LEDs with different wavelengths reacting to movement
in different ways can allow for signal recovery with standard signal processing techniques.
The availability of accelerometer information can also be used to compensate for coarse
movement signal corruption. In order to increase the range of movements that the algorithm
can successfully filter out, an aspect utilizes techniques that augment the algorithm
already in place. For example, filtering violent movements of the arm during very
short periods of time, such as boxing as exercising, may be utilized by the system.
By selective sampling and interpolating over these impulses, an aspect can account
for more extreme cases of motion. Additionally, an investigation into different LED
wavelengths, intensities, and configurations can allow the systems described herein
to extract a signal across a wide spectrum of skin types and wrist sizes. In other
words, motion filtering algorithms and signal processing techniques may assist in
mitigating the risk caused by movement.
[0046] Figure 3 is a flowchart illustrating an exemplary signal processing algorithm for
generating a sequence of heart rates for every detected heartbeat that is embodied
in computer-executable instructions stored on one or more non-transitory computer-readable
media. In step 302, light emitters of a wearable physiological measurement system
emit light toward a user's skin. In step 304, light reflected from the user's skin
is detected at the light detectors in the system. In step 306, signals or data associated
with the reflected light are pre-processed using any suitable technique to facilitate
detection of heart beats. In step 308, a processing module of the system executes
one or more computer-executable instructions associated with a peak detection algorithm
to process data corresponding to the reflected light to detect a plurality of peaks
associated with a plurality of beats of the user's heart. In step 310, the processing
module determines an RR interval based on the plurality of peaks detected by the peak
detection algorithm. In step 312, the processing module determines a confidence level
associated with the RR interval.
[0047] Based on the confidence level associated with the RR interval estimate, the processing
module selects either the peak detection algorithm or a frequency analysis algorithm
to process data corresponding to the reflected light to determine the sequence of
instantaneous heart rates of the user. The frequency analysis algorithm may process
the data corresponding to the reflected light based on the motion of the user detected
using, for example, an accelerometer. The processing module may select the peak detection
algorithm or the frequency analysis algorithm regardless of a motion status of the
user. It is advantageous to use the confidence in the estimate in deciding whether
to switch to frequency-based methods as certain frequency-based approaches are unable
to obtain accurate RR intervals for heart rate variability analysis. Therefore, an
implementation maintains the ability to obtain the RR intervals for as long as possible,
even in the case of motion, thereby maximizing the information that can be extracted.
[0048] For example, in step 314, it is determined whether the confidence level associated
with the RR interval is above (or equal to or above) a threshold. In certain embodiments,
the threshold may be predefined, for example, about 50%-90% in some embodiments and
about 80% in one non-limiting embodiment. In other embodiments, the threshold may
be adaptive, i.e., the threshold may be dynamically and automatically determined based
on previous confidence levels. For example, if one or more previous confidence levels
were high (i.e., above a certain level), the system may determine that a present confidence
level that is relatively low compared to the previous levels is indicative of a less
reliable signal. In this case, the threshold may be dynamically adjusted to be higher
so that a frequency-based analysis method may be selected to process the less reliable
signal.
[0049] If the confidence level is above (or equal to or above) the threshold, in step 316,
the processing module may use the plurality of peaks to determine an instantaneous
heart rate of the user. On the other hand, in step 320, based on a determination that
the confidence level associated with the RR interval is equal to or below the predetermined
threshold, the processing module may execute one or more computer-executable instructions
associated with the frequency analysis algorithm to determine an instantaneous heart
rate of the user. The confidence threshold may be dynamically set based on previous
confidence levels.
[0050] In some embodiments, in steps 318 or 322, the processing module determines a heart
rate variability of the user based on the sequence of the instantaneous heart rates/beats.
[0051] The system may include a display device configured to render a user interface for
displaying the sequence of the instantaneous heart rates of the user, the RR intervals
and/or the heart rate variability determined by the processing module. The system
may include a storage device configured to store the sequence of the instantaneous
heart rates, the RR intervals and/or the heart rate variability determined by the
processing module.
[0052] In one aspect, the system may switch between different analytical techniques for
determining a heart rate such as a statistical technique for detecting a heart rate
and a frequency domain technique for detecting a heart rate. These two different modes
have different advantages in terms of accuracy, processing efficiency, and information
content, and as such may be useful at different times and under different conditions.
Rather than selecting one such mode or technique as an attempted optimization, the
system may usefully switch back and forth between these differing techniques, or other
analytical techniques, using a predetermined criterion. An exemplary statistical technique
employs probabilistic peak detection. An exemplary frequency analysis algorithm used
in an implementation isolates the highest frequency components of the optical data,
checks for harmonics common in both the accelerometer data and the optical data, and
performs filtering of the optical data. This latter algorithm may, for example, take
as input raw analog signals from the accelerometer (3-axis) and pulse sensors, and
output heart rate values or beats per minute (BPM) for a given period of time related
to the window of the spectrogram.
[0053] The exemplary wearable system computes heart rate variability (HRV) to obtain an
understanding of the recovery status of the body. These values are captured right
before a user awakes or when the user is not moving, in both cases photoplethysmography
(PPG) variability yielding equivalence to the ECG HRV. HRV is traditionally measured
using an ECG machine and obtaining a time series of R-R intervals. Because an exemplary
wearable system utilizes photoplethysmography (PPG), it does not obtain the electric
signature from the heart beats; instead, the peaks in the obtained signal correspond
to arterial blood volume. At rest, these peaks are directly correlated with cardiac
cycles, which enables the calculation of HRV via analyzing peak-to-peak intervals
(the PPG analog of RR intervals). It has been demonstrated in medical literature that
these peak-to-peak intervals, the "PPG variability," is identical to ECG HRV while
at rest.
[0054] An exemplary system may include a processing module that is configured to automatically
adjust one or more operational characteristics of the light emitters and/or the light
detectors to minimize power consumption while ensuring that all heart beats of the
user are reliably and continuously detected. The operational characteristics may include,
but are not limited to, a frequency of light emitted by the light emitters, the number
of light emitters activated, a duty cycle of the light emitters, a brightness of the
light emitters, a sampling rate of the light detectors, and the like. The processing
module may adjust the operational characteristics based on one or more signals or
indicators obtained or derived from one or more sensors in the system including, but
not limited to, a motion status of the user, a sleep status of the user, historical
information on the user's physiological and/or habits, an environmental or contextual
condition (e.g., ambient light conditions), a physical characteristic of the user
(e.g., the optical characteristics of the user's skin), and the like.
[0055] In one embodiment, the processing module may receive data on the motion of the user
using, for example, an accelerometer. The processing module may process the motion
data to determine a motion status of the user which indicates the level of motion
of the user, for example, exercise, light motion (e.g., walking), no motion or rest,
sleep, and the like. The processing module may adjust the duty cycle of one or more
light emitters and the corresponding sampling rate of the one or more light detectors
based on the motion status. For example, light emitters for PPG may be activated at
a duty cycle ranging from about 1% to about 100%. In another example, the light emitters
may be activated at a duty cycle ranging from about 20% to about 50% to minimize power
consumption. Certain exemplary sampling rates of the light detectors may range from
about 50 Hz to about 1000 Hz, but are not limited to these exemplary rates. Certain
non-limiting sampling rates are, for example, about 100 Hz, 200 Hz, 500 Hz, and the
like.
[0056] In one non-limiting example, the light detectors may sample continuously when the
user is performing an exercise routine so that the error standard deviation is kept
within 5 beats per minute (BPM). When the user is at rest, the light detectors may
be activated for about a 1% duty cycle-10 milliseconds each second (i.e., 1% of the
time) so that the error standard deviation is kept within 5 BPM (including an error
standard deviation in the heart rate measurement of 2 BPM and an error standard deviation
in the heart rate changes between measurement of 3 BPM). When the user is in light
motion (e.g., walking), the light detectors may be activated for about a 10% duty
cycle-100 milliseconds each second (i.e., 10% of the time) so that the error standard
deviation is kept within 6 BPM (including an error standard deviation in the heart
rate measurement of 2 BPM and an error standard deviation in the heart rate changes
between measurement of 4 BPM).
[0057] The processing module may adjust the brightness of one or more light emitters by
adjusting the current supplied to the light emitters. For example, a first level of
brightness may be set by current ranging between about 1 mA to about 10 mA, but is
not limited to this exemplary range. A second higher level of brightness may be set
by current ranging from about 11 mA to about 30 mA, but is not limited to this exemplary
range. A third higher level of brightness may be set by current ranging from about
80 mA to about 120 mA, but is not limited to this exemplary range. In one non-limiting
example, first, second and third levels of brightness may be set by current of about
5 mA, about 20 mA and about 100 mA, respectively.
[0058] Shorter-wavelength LEDs may require more power than is required by other types of
heart rate sensors, such as, a piezo-sensor or an infrared sensor. Therefore, an exemplary
wearable system may provide and use a unique combination of sensors-one or more light
detectors for periods where motion is expected and one or more piezo and/or infrared
sensors for low motion periods (e.g., sleep)-to save battery life. Certain other embodiments
of a wearable system may exclude piezo-sensors and/or infrared sensors.
[0059] For example, upon determining that the motion status indicates that the user is at
a first higher level of motion (e.g., exercising), one or more light emitters may
be activated to emit light at a first wavelength. Upon determining that the motion
status indicates that the user is at a second lower level of motion (e.g., at rest),
non-light based sensors may be activated. The threshold levels of motion that trigger
adjustment of the type of sensor may be based on one or more factors including, but
are not limited to, skin properties, ambient light conditions, and the like.
[0060] The system may determine the type of sensor to use at a given time based on the level
of motion (e.g., via an accelerometer) and whether the user is asleep (e.g., based
on movement input, skin temperature and heart rate). Based on a combination of these
factors the system selectively chooses which type of sensor to use in monitoring the
heart rate of the user. Common symptoms of being asleep are periods of no movement
or small bursts of movement (such as shifting in bed), lower skin temperature (although
it is not a dramatic drop from normal), drastic GSR changes, and heart rate that is
below the typical resting heart rate when the user is awake. These variables depend
on the physiology of a person and thus a machine learning algorithm is trained with
user-specific input to determine when he/she is awake/asleep and determine from that
the exact parameters that cause the algorithm to deem someone asleep.
[0061] In an exemplary configuration, the light detectors may be positioned on the underside
of the wearable system and all of the heart rate sensors may be positioned adjacent
to each other. For example, the low power sensor(s) may be adjacent to the high power
sensor(s) as the sensors may be chosen and placed where the strongest signal occurs.
In one example configuration, a 3-axis accelerometer may be used that is located on
the top part of the wearable system. In some embodiments, an operational characteristic
of the microprocessor may be automatically adjusted to minimize power consumption.
This adjustment may be based on a level of motion of the user's body.
[0062] More generally, the above description contemplates a variety of techniques for sensing
conditions relating to heart rate monitoring or related physiological activity either
directly (e.g., confidence levels or accuracy of calculated heart rate) or indirectly
(e.g., motion detection, temperature). However measured, these sensed conditions can
be used to intelligently select from among a number of different modes, including
hardware modes, software modes, and combinations of the foregoing, for monitoring
heart rate based on, e.g., accuracy, power usage, detected activity states, and so
forth. Thus there is disclosed herein techniques for selecting from among two or more
different heart rate monitoring modes according to a sensed condition.
[0063] Exemplary embodiments provide an analytics system for providing qualitative and quantitative
monitoring of a user's body, health and physical training. The analytics system is
implemented in computer-executable instructions encoded on one or more non-transitory
computer-readable media. The analytics system relies on and uses continuous data on
one or more physiological parameters including, but not limited to, heart rate. The
continuous data used by the analytics system may be obtained or derived from an exemplary
physiological measurement system disclosed herein, or may be obtained or derived from
a derived source or system, for example, a database of physiological data. In some
embodiments, the analytics system computes, stores and displays one or more indicators
or scores relating to the user's body, health and physical training including, but
not limited to, an intensity score and a recovery score. The scores may be updated
in real-time and continuously or at specific time periods, for example, the recovery
score may be determined every morning upon waking up, the intensity score may be determined
in real-time or after a workout routine or for an entire day.
[0064] In certain exemplary embodiments, a fitness score may be automatically determined
based on the physiological data of two or more users of exemplary wearable systems.
[0065] An intensity score or indicator provides an accurate indication of the cardiovascular
intensities experienced by the user during a portion of a day, during the entire day
or during any desired period of time (e.g., during a week or month). The intensity
score is customized and adapted for the unique physiological properties of the user
and takes into account, for example, the user's age, gender, anaerobic threshold,
resting heart rate, maximum heart rate, and the like. If determined for an exercise
routine, the intensity score provides an indication of the cardiovascular intensities
experienced by the user continuously throughout the routine. If determined for a period
of including and beyond an exercise routine, the intensity score provides an indication
of the cardiovascular intensities experienced by the user during the routine and also
the activities the user performed after the routine (e.g., resting on the couch, active
day of shopping) that may affect their recovery or exercise readiness.
[0066] In exemplary embodiments, the intensity score is calculated based on the user's heart
rate reserve (HRR) as detected continuously throughout the desired time period, for
example, throughout the entire day. In one embodiment, the intensity score is an integral
sum of the weighted HRR detected continuously throughout the desired time period.
Figure 4 is a flowchart illustrating an exemplary method of determining an intensity
score.
[0067] In step 402, continuous heart rate readings are converted to HRR values. A time series
of heart rate data used in step 402 may be denoted as:
H ∈
T
[0068] A time series of HRR measurements, v(t), may be defined in the following expression
in which MHR is the maximum heart rate and RHR is the resting heart rate of the user:
[0069] In step 404, the HRR values are weighted according to a suitable weighting scheme.
Cardiovascular intensity, indicated by an intensity score, is defined in the following
expression in which w is a weighting function of the HRR measurements:
[0070] In step 406, the weighted time series of HRR values is summed and normalized.
[0071] Thus, the weighted sum is normalized to the unit interval, i.e., [0, 1]:
[0072] In step 408, the summed and normalized values are scaled to generate user-friendly
intensity score values. That is, the unit interval is transformed to have any desired
distribution in a scale (e.g., a scale including 21 points from 0 to 21), for example,
arctangent, sigmoid, sinusoidal, and the like. In certain distributions, the intensity
values increase at a linear rate along the scale, and in others, at the highest ranges
the intensity values increase at more than a linear rate to indicate that it is more
difficult to climb in the scale toward the extreme end of the scale. In some embodiments,
the raw intensity scores are scaled by fitting a curve to a selected group of "canonical"
exercise routines that are predefined to have particular intensity scores.
[0073] In one embodiment, monotonic transformations of the unit interval are achieved to
transform the raw HRR values to user-friendly intensity scores. An exemplary scaling
scheme, expressed as
ƒ: [0, 1] → [0, 1], is performed using the following function:
[0074] To generate an intensity score, the resulting value may be multiplied by a number
based on the desired scale of the intensity score. For example, if the intensity score
is graduated from zero to 21, then the value may be multiplied by 21.
[0075] In step 410, the intensity score values are stored on a non-transitory storage medium
for retrieval, display and usage. In step 412, the intensity score values are, in
some embodiments, displayed on a user interface rendered on a visual display device.
The intensity score values may be displayed as numbers and/or with the aid of graphical
tools, e.g., a graphical display of the scale of intensity scores with current score,
and the like. In some embodiments, the intensity score may be indicated by audio.
In step 412, the intensity score values are, in some embodiments, displayed along
with one or more quantitative or qualitative pieces of information on the user including,
but not limited to, whether the user has exceeded his/her anaerobic threshold, the
heart rate zones experienced by the user during an exercise routine, how difficult
an exercise routine was in the context of the user's training, the user's perceived
exertion during an exercise routine, whether the exercise regimen of the user should
be automatically adjusted (e.g., made easier if the intensity scores are consistently
high), whether the user is likely to experience soreness the next day and the level
of expected soreness, characteristics of the exercise routine (e.g., how difficult
it was for the user, whether the exercise was in bursts or activity, whether the exercise
was tapering, etc.), and the like. In one embodiment, the analytics system may automatically
generate, store and display an exercise regimen customized based on the intensity
scores of the user.
[0076] Step 406 may use any of a number of exemplary static or dynamic weighting schemes
that enable the intensity score to be customized and adapted for the unique physiological
properties of the user. In one exemplary static weighting scheme, the weights applied
to the HRR values are based on static models of a physiological process. The human
body employs different sources of energy with varying efficiencies and advantages
at different HRR levels. For example, at the anaerobic threshold (AT), the body shifts
to anaerobic respiration in which the cells produce two adenosine triphosphate (ATP)
molecules per glucose molecule, as opposed to 36 at lower HRR levels. At even higher
HRR levels, there is a further subsequent threshold (CPT) at which creatine triphosphate
(CTP) is employed for respiration with even less efficiency.
[0077] In order to account for the differing levels of cardiovascular exertion and efficiency
at the different HRR levels, in one embodiment, the possible values of HRR are divided
into a plurality of categories, sections or levels (e.g., three) dependent on the
efficiency of cellular respiration at the respective categories. The HRR parameter
range may be divided in any suitable manner, such as, piecewise, including piecewise-linear,
piecewise-exponential, and the like. An exemplary piecewise-linear division of the
HRR parameter range enables weighting each category with strictly increasing values.
This scheme captures an accurate indication of the cardiovascular intensity experienced
by the user because it is more difficult to spend time at higher HRR values, which
suggests that the weighting function should increase at the increasing weight categories.
[0078] In one non-limiting example, the HRR parameter range may be considered a range from
zero (0) to one (1) and divided into categories with strictly increasing weights.
In one example, the HRR parameter range may be divided into a first category of a
zero HRR value and may assign this category a weight of zero; a second category of
HRR values falling between zero (0) and the user's anaerobic threshold (AT) and may
assign this category a weight of one (1); a third category of HRR values falling between
the user's anaerobic threshold (AT) and a threshold at which the user's body employs
creatine triphosphate for respiration (CPT) and may assign this category a weight
of 18; and a fourth category of HRR values falling between the creatine triphosphate
threshold (CPT) and one (1) and may assign this category a weight of 42, although
other numbers of HRR categories and different weight values are possible. That is,
in this example, the weights are defined as:
[0079] In another exemplary embodiment of the weighting scheme, the HRR time series is weighted
iteratively based on the intensity scores determined thus far (e.g., the intensity
score accrued thus far) and the path taken by the HRR values to get to the present
intensity score. In another exemplary embodiment of the weighting scheme, a predictive
approach is used by modeling the weights or coefficients to be the coefficient estimates
of a logistic regression model. One of ordinary skill in the art will recognize that
two or more aspects of any of the disclosed weighting schemes may be applied separately
or in combination in an exemplary method for determining an intensity score.
[0080] In one aspect, heart rate zones quantify the intensity of workouts by weighing and
comparing different levels of heart activity as percentages of maximum heart rate.
Analysis of the amount of time an individual spends training at a certain percentage
of his/her MHR may reveal his/her state of physical exertion during a workout. This
intensity, developed from the heart rate zone analysis, motion, and activity, may
then indicate his/her need for rest and recovery after the workout, e.g., to minimize
delayed onset muscle soreness (DOMS) and prepare him/her for further activity. As
discussed above, MHR, heart rate zones, time spent above the anaerobic threshold,
and HRV in RSA (Respiratory Sinus Arrhythmia) regions-as well as personal information
(gender, age, height, weight, etc.) may be utilized in data processing.
[0081] A recovery score or indicator provides an accurate indication of the level of recovery
of a user's body and health after a period of physical exertion. The human autonomic
nervous system controls the involuntary aspects of the body's physiology and is typically
subdivided into two branches: parasympathetic (deactivating) and sympathetic (activating).
Heart rate variability (HRV), i.e., the fluctuation in inter-heartbeat interval time,
is a commonly studied result of the interplay between these two competing branches.
Parasympathetic activation reflects inputs from internal organs, causing a decrease
in heart rate. Sympathetic activation increases in response to stress, exercise and
disease, causing an increase in heart rate. For example, when high intensity exercise
takes place, the sympathetic response to the exercise persists long after the completion
of the exercise. When high intensity exercise is followed by insufficient recovery,
this imbalance lasts typically until the next morning, resulting in a low morning
HRV. This result should be taken as a warning sign as it indicates that the parasympathetic
system was suppressed throughout the night. While suppressed, normal repair and maintenance
processes that ordinarily would occur during sleep were suppressed as well. Suppression
of the normal repair and maintenance processes results in an unprepared state for
the next day, making subsequent exercise attempts more challenging.
[0082] The recovery score is customized and adapted for the unique physiological properties
of the user and takes into account, for example, the user's heart rate variability
(HRV), resting heart rate, sleep quality and recent physiological strain (indicated,
in one example, by the intensity score of the user). In one exemplary embodiment,
the recovery score is a weighted combination of the user's heart rate variability
(HRV), resting heart rate, sleep quality indicated by a sleep score, and recent strain
(indicated, in one example, by the intensity score of the user). In an exemplar, the
sleep score combined with performance readiness measures (such as, morning heart rate
and morning heart rate variability) provides a complete overview of recovery to the
user. By considering sleep and HRV alone or in combination, the user can understand
how exercise-ready he/she is each day and to understand how he/she arrived at the
exercise-readiness score each day, for example, whether a low exercise-readiness score
is a predictor of poor recovery habits or an inappropriate training schedule. This
insight aids the user in adjusting his/her daily activities, exercise regimen and
sleeping schedule therefore obtain the most out of his/her training.
[0083] In some cases, the recovery score may take into account perceived psychological strain
experienced by the user. In some cases, perceived psychological strain may be detected
from user input via, for example, a questionnaire on a mobile device or web application.
In other cases, psychological strain may be determined automatically by detecting
changes in sympathetic activation based on one or more parameters including, but not
limited to, heart rate variability, heart rate, galvanic skin response, and the like.
[0084] With regard to the user's HRV used in determining the recovery score, suitable techniques
for analyzing HRV include, but are not limited to, time-domain methods, frequency-domain
methods, geometric methods and non-linear methods. In one embodiment, the HRV metric
of the root-mean-square of successive differences (RMSSD) of RR intervals is used.
The analytics system may consider the magnitude of the differences between 7-day moving
averages and 3-day moving averages of these readings for a given day. Other embodiments
may use Poincare Plot analysis or other suitable metrics of HRV.
[0085] The recovery score algorithm may take into account RHR along with history of past
intensity and recovery scores.
[0086] With regard to the user's resting heart rate, moving averages of the resting heart
rate are analyzed to determine significant deviations. Consideration of the moving
averages is important since day-to-day physiological variation is quite large even
in healthy individuals. Therefore, the analytics system may perform a smoothing operation
to distinguish changes from normal fluctuations.
[0087] Although an inactive condition, sleep is a highly active recovery state during which
a major portion of the physiological recovery process takes place. Nonetheless, a
small, yet significant, amount of recovery can occur throughout the day by rehydration,
macronutrient replacement, lactic acid removal, glycogen re-synthesis, growth hormone
production and a limited amount of musculoskeletal repair. In assessing the user's
sleep quality, the analytics system generates a sleep score using continuous data
collected by an exemplary physiological measurement system regarding the user's heart
rate, skin conductivity, ambient temperature and accelerometer/gyroscope data throughout
the user's sleep. Collection and use of these four streams of data enable an understanding
of sleep previously only accessible through invasive and disruptive over-night laboratory
testing. For example, an increase in skin conductivity when ambient temperature is
not increasing, the wearer's heart rate is low, and the accelerometer/gyroscope shows
little motion, may indicate that the wearer has fallen asleep. The sleep score indicates
and is a measure of sleep efficiency (how good the user's sleep was) and sleep duration
(if the user had sufficient sleep). Each of these measures is determined by a combination
of physiological parameters, personal habits and daily stress/strain (intensity) inputs.
The actual data measuring the time spent in various stages of sleep may be combined
with the wearer's recent daily history and a longer-term data set describing the wearer's
personal habits to assess the level of sleep sufficiency achieved by the user. The
sleep score is designed to model sleep quality in the context of sleep duration and
history. It thus takes advantage of the continuous monitoring nature of the exemplary
physiological measurement systems disclosed herein by considering each sleep period
in the context of biologically-determined sleep needs, pattern-determined sleep needs
and historically-determined sleep debt.
[0088] The recovery and sleep score values are stored on a non-transitory storage medium
for retrieval, display and usage. The recovery and/or sleep score values are, in some
embodiments, displayed on a user interface rendered on a visual display device. The
recovery and/or sleep score values may be displayed as numbers and/or with the aid
of graphical tools, e.g., a graphical display of the scale of recovery scores with
current score, and the like. In some embodiments, the recovery and/or sleep score
may be indicated by audio. The recovery score values are, in some embodiments, displayed
along with one or more quantitative or qualitative pieces of information on the user
including, but not limited to, whether the user has recovered sufficiently, what level
of activity the user is prepared to perform, whether the user is prepared to perform
an exercise routine a particular desired intensity, whether the user should rest and
the duration of recommended rest, whether the exercise regimen of the user should
be automatically adjusted (e.g., made easier if the recovery score is low), and the
like. In one embodiment, the analytics system may automatically generate, store and
display an exercise regimen customized based on the recovery scores of the user alone
or in combination with the intensity scores.
[0089] As discussed above, the sleep performance metric may be based on parameters like
the number of hours of sleep, sleep onset latency, and the number of sleep disturbances.
In this manner, the score may compare a tactical athlete's duration and quality of
sleep in relation to the tactical athlete's evolving sleep need (e.g., a number of
hours based on recent strain, habitual sleep need, signs of sickness, and sleep debt).
By way of example, a soldier may have a dynamically changing need for sleep, and it
may be important to consider the total hours of sleep in relation to the amount of
sleep that may have been required. By providing an accurate sensor for sleep and sleep
performance, an aspect may evaluate sleep in the context of the overall day and lifestyle
of a specific user.
[0090] Figure 5 is a flowchart illustrating an exemplary method by which a user may use
intensity and recovery scores. In step 502, the wearable physiological measurement
system begins determining heart rate variability (HRV) measurements based on continuous
heart rate data collected by an exemplary physiological measurement system. In some
cases, it may take the collection of several days of heart rate data to obtain an
accurate baseline for the HRV. In step 504, the analytics system may generate and
display intensity score for an entire day or an exercise routine. In some cases, the
analytics system may display quantitative and/or qualitative information corresponding
to the intensity score.
[0091] In step 506, in an exemplary embodiment, the analytics system may automatically generate
or adjust an exercise routine or regimen based on the user's actual intensity scores
or desired intensity scores. For example, based on inputs of the user's actual intensity
scores, a desired intensity score (that is higher than the actual intensity scores)
and a first exercise routine currently performed by the user (e.g., walking), the
analytics system may recommend a second different exercise routine that is typically
associated with higher intensity scores than the first exercise routine (e.g., running).
[0092] In step 508, at any given time during the day (e.g., every morning), the analytics
system may generate and display a recovery score. In some cases, the analytics system
may display quantitative and/or qualitative information corresponding to the intensity
score. For example, in step 510, in an exemplary embodiment, the analytics system
may determine if the recovery is greater than (or equal to or greater than) a first
predetermined threshold (e.g., about 60% to about 80% in some examples) that indicates
that the user is recovered and is ready for exercise. If this is the case, in step
512, the analytics system may indicate that the user is ready to perform an exercise
routine at a desired intensity or that the user is ready to perform an exercise routine
more challenging than the past day's routine. Otherwise, in step 514, the analytics
system may determine if the recovery is lower than (or equal to or lower than) a second
predetermined threshold (e.g., about 10% to about 40% in some examples) that indicates
that the user has not recovered. If this is the case, in step 516, the analytics system
may indicate that the user should not exercise and should rest for an extended period.
The analytics system may, in some cases, the duration of recommended rest. Otherwise,
in step 518, the analytics system may indicate that the user may exercise according
to his/her exercise regimen while being careful not to overexert him/herself. The
thresholds may, in some cases, be adjusted based on a desired intensity at which the
user desires to exercise. For example, the thresholds may be increased for higher
planned intensity scores.
[0093] Figure 6 is a flow chart illustrating a method for detecting heart rate variability
in sleep states. The method 600 may be used in cooperation with any of the devices,
systems, and methods described herein, such as by operating a wearable, continuous
physiological monitoring device to perform the following steps. The wearable, continuous
physiological monitoring system may for example include a processor, one or more light
emitting diodes, one or more light detectors configured to obtain heart rate data
from a user, and one or more other sensors to assist in detecting stages of sleep.
In general, the method 600 aims to measure heart rate variability in the last phase
of sleep before waking in order to provide a consistent and accurate basis for calculating
a physical recovery score.
[0094] As shown in step 602, the method 600 may include detecting a sleep state of a user.
This may, for example, include any form of continuous or periodic monitoring of sleep
states using any of a variety of sensors or algorithms as generally described herein.
[0095] Sleep states (also be referred to as "sleep phases," "sleep cycles," "sleep stages,"
or the like) may include rapid eye movement (REM) sleep, non-REM sleep, or any states/stages
included therein. The sleep states may include different phases of non-REM sleep,
including Stages 1-3. Stage 1 of non-REM sleep generally includes a state where a
person's eyes are closed, but the person can be easily awakened; Stage 2 of non-REM
sleep generally includes a state where a person is in light sleep, i.e., where the
person's heart rate slows and their body temperature drops in preparation for deeper
sleep; and Stage 3 of non-REM sleep generally includes a state of deep sleep, where
a person is not easily awakened. Stage 3 is often referred to as delta sleep, deep
sleep, or slow wave sleep (i.e., from the high amplitude but small frequency brain
waves typically found in this stage). Slow wave sleep is thought to be the most restful
form of sleep, which relieves subjective feelings of sleepiness and restores the body.
[0096] REM sleep on the other hand typically occurs 1-2 hours after falling asleep. REM
sleep may include different periods, stages, or phases, all of which may be included
within the sleep states that are detected as described herein. During REM sleep, breathing
may become more rapid, irregular and shallow, eyes may jerk rapidly (thus the term
"Rapid Eye Movement" or "REM"), and limb muscles may be temporarily paralyzed. Brain
waves during this stage typically increase to levels experienced when a person is
awake. Also, heart rate, cardiac pressure, cardiac output, and arterial pressure may
become irregular when the body moves into REM sleep. This is the sleep state in which
most dreams occur, and, if awoken during REM sleep, a person can typically remember
the dreams. Most people experience three to five intervals of REM sleep each night.
[0097] Homeostasis is the balance between sleeping and waking, and having proper homeostasis
may be beneficial to a person's health. Lack of sleep is commonly referred to as sleep
deprivation, which tends to cause slower brain waves, a shorter attention span, heightened
anxiety, impaired memory, mood disorders, and general mental, emotional, and physical
fatigue. Sleep debt (the effect of not getting enough sleep) may result in the diminished
abilities to perform high-level cognitive functions. A person's circadian rhythms
(i.e., biological processes that display an endogenous, entrainable oscillation of
about 24 hours) may be a factor in a person's optimal amount of sleep. Thus, sleep
may in general be usefully monitored as a proxy for physical recovery. However, a
person's heart rate variability at a particular moment during sleep - during the last
phase of sleep preceding a waking event -- can further provide an accurate and consistent
basis for objectively calculating a recovery score following a period of sleep.
[0098] According to the foregoing, sleep of a user may be monitored to detect various sleep
states, transitions, and other sleep-related information. For example, the device
may monitor/detect the duration of sleep states, the transitions between sleep states,
the number of sleep cycles or particular states, the number of transitions, the number
of waking events, the transitions to an awake state, and so forth. Sleep states may
be monitored and detected using a variety of strategies and sensor configurations
according to the underlying physiological phenomena. For example, body temperature
may be usefully correlated to various sleep states and transitions. Similarly, galvanic
skin response may be correlated to sweating activity and various sleep states, any
of which may also be monitored, e.g., with a galvanic skin response sensor, to determine
sleep states. Physical motion can also be easily monitored using accelerometers or
the like, which can be used to detect waking or other activity involving physical
motion. In another aspect, heart rate activity itself may be used to infer various
sleep states and transitions, either alone or in combination with other sensor data.
Other sensors may also or instead be used to monitor sleep activity, such as brain
wave monitors, pupil monitors, and so forth, although the ability to incorporate these
types of detection into a continuously wearable physiological monitoring device may
be somewhat limited depending on the contemplated configuration.
[0099] As shown in step 604, the method 600 may include monitoring a heart rate of the user
substantially continuously with the continuous physiological monitoring system. Continuous
heart rate monitoring is described above in significant detail, and the description
is not repeated here except to note generally that this may include raw sensor data,
heart rate data or peak data, and heart rate variability data over some historical
period that can be subsequently correlated to various sleep states and activities.
[0100] As shown in step 606, the method 600 may include recording the heart rate as heart
rate data. This may include storing the heart rate data in any raw or processed form
on the device, or transmitting the data to a local or remote location for storage.
In one aspect, the data may be stored as peak-to-peak data or in some other semi-processed
form without calculating heart rate variability. This may be useful as a technique
for conserving processing resources in a variety of contexts, for example where only
the heart rate variability at a particular time is of interest. Data may be logged
in some unprocessed or semi-processed form, and then the heart rate variability at
a particular point in time can be calculated once the relevant point in time has been
identified.
[0101] As shown in step 610, the method 600 may include detecting a waking event at a transition
from the sleep state of the user to an awake state. It should be appreciated that
the waking event may be a result of a natural termination of sleep, e.g., after a
full night's rest, or in response to an external stimulus that causes awakening prior
to completion of a natural sleep cycle. Regardless of the precipitating event(s),
the waking event may be detected via the various physiological changes described above,
or using any other suitable techniques. While the emphasis herein is on a wearable,
continuous monitoring device, it will be understood that the device may also receive
inputs from an external device such as a camera (for motion detection) or an infrared
camera (for body temperature detection) that can be used to aid in accurately assessing
various sleep states and transitions.
[0102] Thus the wearable, continuous physiological monitoring system may generally detect
a waking event using one or more sensors including, for example, one or more of an
accelerometer, a galvanic skin response sensor, a light sensor, and so forth. For
example, in one aspect, the waking event may be detected using a combination of motion
data and heart rate data.
[0103] As shown in step 612, the method 600 may include calculating a heart rate variability
of the user at a moment in a last phase of sleep preceding the waking event based
upon the heart rate data. While a waking event and a history of sleep states are helpful
information for assessing recovery, the method 600 described herein specifically contemplates
use of the heart rate variability in a last phase of sleep as a consistent foundation
for calculating recovery scores for a device user. Thus step 612 may also include
detecting a slow wave sleep period immediately prior to the waking event, or otherwise
determining the end of a slow wave or deep sleep episode immediately preceding the
waking event.
[0104] It will be appreciated that the last phase of sleep preceding a natural waking event
may be slow wave sleep. However, where a sleeper is awakened prematurely, this may
instead include a last recorded episode of REM sleep or some other phase of sleep
immediately preceding the waking event. This moment - the end of the last phase of
sleep before waking -- is the point at which heart rate variability data provides
the most accurate and consistent indicator of physical recovery. Thus, with the appropriate
point of time identified, the historical heart rate data (in whatever form) may be
used with the techniques described above to calculate the corresponding heart rate
variability. It will be further noted that the time period for this calculation may
be selected with varying degrees of granularity depending on the ability to accurate
detect the last phase of sleep and an end of the last phase of sleep. Thus for example,
the time may be a predetermined amount of time before waking, or at the end of slow
wave sleep, or some predetermined amount of time before the end of slow wave sleep
is either detected or inferred. In another aspect, an average heart rate variability
or similar metric may be determined for any number of discrete measurements within
a window around the time of interest.
[0105] As shown in step 614, the method 600 may include calculating a duration of the sleep
state. The quantity and quality of sleep may be highly relevant to physical recovery,
and as such the duration of the sleep state may be used to calculate a recovery score.
[0106] As shown in step 618, the method 600 may include evaluating a quality of heart rate
data using a data quality metric for a slow wave sleep period, e.g., the slow wave
sleep period occurring most recently before the waking event. As noted above, the
quality of heart rate measurements may vary over time for a variety of reasons. Thus
the quality of heart rate data may be evaluated prior to selecting a particular moment
or window of heart rate data for calculating heart rate variability, and the method
600 may include using this quality data to select suitable values for calculating
a recovery score. For example, the method 600 may include calculating the heart rate
variability for a window of predetermined duration within the slow wave sleep period
having the highest quality of heart rate data according to the data quality metric.
[0107] As shown in step 620, the method 600 may include calculating a recovery score for
the user based upon the heart rate variability from the last phase of sleep. The calculation
may be based on other sources of data. For example, the calculation of recovery score
may be based on the duration of sleep, the stages of sleep detected or information
concerning the stages (e.g., amount of time in certain stages), information regarding
the most recent slow wave sleep period or another sleep period/state, information
from the GSR sensor or other sensor(s), and so on. The method 600 may further include
calculating additional recovery scores after one or more other waking events of the
user for comparison to the previously calculated recovery score. The actual calculation
of a discovery score is described in substantial detail above, and this description
is not repeated here except to note that the use of a heart rate variability measurement
from the last phase of sleep provides an accurate and consistent basis for evaluating
the physical recovery state of a user following a period of sleep.
[0108] As shown in step 630, the method 600 may include calculating a sleep score and communicating
this score to a user.
[0109] In one aspect, the sleep score may be a measure of prior sleep performance. For example,
a sleep performance score may quantify, on a scale of 0-100, the ratio of the hours
of sleep during a particular resting period compared to the sleep needed. On this
scale, if a user sleeps six hours and needed eight hours of sleep, then the sleep
performance may be calculated as 75%. The sleep performance score may begin with one
or more assumptions about needed sleep, based on, e.g., age, gender, health, fitness
level, habits, genetics, and so forth and may be adapted to actual sleep patterns
measured for an individual over time.
[0110] The sleep score may also or instead include a sleep need score or other objective
metric that estimates an amount of sleep needed by the user of the device in a next
sleep period. In general, the score may be any suitable quantitative representation
including, e.g., a numerical value over some predetermined scale (e.g., 0-10, 1-100,
or any other suitable scale) or a representation of a number of hours of sleep that
should be targeted by the user. In another aspect, the sleep score may be calculated
as the number of additional hours of sleep needed beyond a normal amount of sleep
for the user.
[0111] The score may be calculated using any suitable inputs that capture, e.g., a current
sleep deficit, a measure of strain or exercise intensity over some predetermined prior
interval, an accounting for any naps or other resting, and so forth. A variety of
factors may affect the actual sleep need, including physiological attributes such
as age, gender, health, genetics and so forth, as well as daytime activities, stress,
napping, sleep deficit or deprivation, and so forth. The sleep deficit may itself
be based on prior sleep need and actual sleep performance (quality, duration, waking
intervals, etc.) over some historical window. In one aspect, an objective scoring
function for sleep need may have a model of the form:
[0112] In general, this calculation aims to estimate the ideal amount of sleep for best
rest and recovery during a next sleep period. When accounting for time falling asleep,
periods of brief wakefulness, and so forth, the actual time that should be dedicated
to sleep may be somewhat higher, and this may be explicitly incorporated into the
sleep need calculation, or left for a user to appropriately manage sleep habits.
[0113] In general, the baseline sleep may represent a standard amount of sleep needed by
the user on a typical rest day (e.g., with no strenuous exercise or workout). As noted
above, this may depend on a variety of factors, and may be estimated or measured for
a particular individual in any suitable manner. The strain component,
ƒ1(
strain), may be assessed based on a previous day's physical intensity, and will typically
increase the sleep need. Where intensity or strain is measured on an objective scale
from 0 to 21, the strain calculation may take the following form, which yields an
additional sleep time needed in minutes for a strain, i:
[0114] The sleep debt
, ƒ2(
debt)
, may generally measure a carryover of needed sleep that was not attained in a previous
day. This may be scaled, and may be capped at a maximum, according to individual sleep
characteristics or general information about long term sleep deficit and recovery.
Naps may also be accounted for directly by correcting the sleep need for any naps
that have been taken, or by calculating a nap factor that is scaled or otherwise manipulated
or calculated to more accurately track the actual effect of naps on prospective sleep
need.
[0115] However calculated, the sleep need may be communicated to a user, such as by displaying
a sleep need on a wrist-worn physiological monitoring device, or by sending an e-mail,
text message or other alert to the user for display on any suitable device.
[0116] Fig. 7 is a bottom view of a wearable, continuous physiological monitoring device
(the side facing a user's skin). As shown in the figure, the wearable, continuous
physiological monitoring system 700 includes a wearable housing 702, one or more sensors
704, a processor 706, and a light source 708.
[0117] The wearable housing 702 may be configured such that a user can wear a continuous
physiological monitoring device as part of the wearable, continuous physiological
monitoring system 700. The wearable housing 702 may be configured for cooperation
with a strap or the like, e.g., for engagement with an appendage of a user.
[0118] The one or more sensors 704 may be disposed in the wearable housing 702. In one aspect,
the one or more sensors 704 include a light detector configured to provide data to
the processor 706 for calculating a heart rate variability. The one or more sensors
704 may also or instead include an accelerometer configured to provide data to the
processor 706 for detecting a sleep state or a waking event. In an implementation,
the one or more sensors 704 measure a galvanic skin response of the user.
[0119] The processor 706 may be disposed in the wearable housing 702. The processor 706
may be configured to operate the one or more sensors 704 to detect a sleep state of
a user wearing the wearable housing 702. The processor 706 may be further configured
to monitor a heart rate of the user substantially continuously, and to record the
heart rate as heart rate data without calculating a heart rate variability for the
user. The processor 706 may also or instead be configured to detect a waking event
at a transition from the sleep state of the user to an awake state, and to calculate
the heart rate variability of the user at a moment in the last phase of sleep preceding
the waking event based upon the heart rate data. The processor 706 may further be
configured to calculate a recovery score for the user based upon the heart rate variability
from the last phase of sleep.
[0120] The light source 708 may be coupled to the wearable housing 702 and controlled by
the processor 706. The light source 708 may be directed toward the skin of a user's
appendage. Light from the light source 708 may be detected by the one or more sensors
704.
[0121] The above systems, devices, methods, processes, and the like may be realized in hardware,
software, or any combination of these suitable for the control, data acquisition,
and data processing described herein. This includes realization in one or more microprocessors,
microcontrollers, embedded microcontrollers, programmable digital signal processors
or other programmable devices or processing circuitry, along with internal and/or
external memory. This may also, or instead, include one or more application specific
integrated circuits, programmable gate arrays, programmable array logic components,
or any other device or devices that may be configured to process electronic signals.
It will further be appreciated that a realization of the processes or devices described
above may include computer-executable code created using a structured programming
language such as C, an object oriented programming language such as C++, or any other
high-level or low-level programming language (including assembly languages, hardware
description languages, and database programming languages and technologies) that may
be stored, compiled or interpreted to run on one of the above devices, as well as
heterogeneous combinations of processors, processor architectures, or combinations
of different hardware and software.
[0122] Thus, in one aspect, each method described above and combinations thereof may be
embodied in computer executable code that, when executing on one or more computing
devices, performs the steps thereof. In another aspect, the methods may be embodied
in systems that perform the steps thereof, and may be distributed across devices in
a number of ways, or all of the functionality may be integrated into a dedicated,
standalone device or other hardware. The code may be stored in a non-transitory fashion
in a computer memory, which may be a memory from which the program executes (such
as random access memory associated with a processor), or a storage device such as
a disk drive, flash memory or any other optical, electromagnetic, magnetic, infrared
or other device or combination of devices. In another aspect, any of the systems and
methods described above may be embodied in any suitable transmission or propagation
medium carrying computer-executable code and/or any inputs or outputs from same. In
another aspect, means for performing the steps associated with the processes described
above may include any of the hardware and/or software described above. All such permutations
and combinations are intended to fall within the scope of the present disclosure.
[0123] It should further be appreciated that the methods above are provided by way of example.
Absent an explicit indication to the contrary, the disclosed steps may be modified,
supplemented, omitted, and/or re-ordered without departing from the scope of this
disclosure.
[0124] It will be appreciated that the methods and systems described above are set forth
by way of example and not of limitation. Numerous variations, additions, omissions,
and other modifications will be apparent to one of ordinary skill in the art. In addition,
the order or presentation of method steps in the description and drawings above is
not intended to require this order of performing the recited steps unless a particular
order is expressly required or otherwise clear from the context. Thus, while particular
embodiments have been shown and described, it will be apparent to those skilled in
the art that various changes and modifications in form and details may be made therein
without departing from the scope of the invention, which is solely defined by the
appended claims.